Susan Nolen-Hoeksema, 53, Yale psychologist wrote about depression in women

NEW YORK — Susan Nolen-Hoeksema, a psychologist and writer whose work helped explain why women are twice as prone to depression as men and why such low moods can be so hard to shake, died Jan. 2 in New Haven. She was 53.

Her death followed heart surgery to correct a weak valve, said her husband, Richard.

A professor at Yale University, she began studying depression in the 1980s, a time of excitement in psychiatry and psychology. New drugs like Prozac were entering the market. Novel talking therapies were effective, too, particularly cognitive behavior therapy, in which people defuse upsetting thoughts by questioning their basis.

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Her studies, first in children and later in adults, exposed one of the most deceptively upsetting of these patterns: rumination, theinstinct to dwell on the sources of problems rather than their solutions. Women were more prone to ruminate, the studies found, and in a landmark 1987 paper she argued that this difference accounted for the 2-to-1 ratio of depressed women to depressed men.

She later linked rumination to a variety of mood and behavior problems, including anxiety, eating disorders, and substance abuse.